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Olfactory Dysfunction in Nasal Bone Fracture

  • Kim, Sug Won (Department of Plastic and Reconstructive Surgery, Wonju College of Medicine, Yonsei University) ;
  • Park, Beom (Department of Plastic and Reconstructive Surgery, Wonju College of Medicine, Yonsei University) ;
  • Lee, Tae Geun (Department of Plastic and Reconstructive Surgery, Wonju College of Medicine, Yonsei University) ;
  • Kim, Ji Ye (Department of Plastic and Reconstructive Surgery, Wonju College of Medicine, Yonsei University)
  • Received : 2017.05.15
  • Accepted : 2017.06.13
  • Published : 2017.06.20

Abstract

Background: All nasal bone fractures have the potential for worsening of olfactory function. However, few studies have studied the olfactory outcomes following reduction of nasal bone fractures. This study evaluates posttraumatic olfactory dysfunction in patients with nasal bone fracture before and after closed reduction. Methods: A prospective study was conducted for all patients presenting with nasal bone fracture (n=97). Each patient consenting to the study underwent the Korean version of Sniffin' Sticks test (KVSS II) before operation and at 6 month after closed reduction. The nasal fractures were divided according to the nasal bone fracture classification by Haug and Prather (Types I-IV). The olfactory scores were compared across fracture types and between preoperative and postoperative settings. Results: Olfactory dysfunction was frequent after nasal fracture (45/97, 46.4%). Our olfactory assessment using the KVSS II test revealed that fracture reduction was not associated with improvements in the mean test score in Type I or Type II fractures. More specifically, the mean posttraumatic Threshold, discrimination and identification score decreased from 28.8 points prior to operation to 23.1 point at 6 months for Type II fracture with septal fracture. Conclusion: Our study has revealed two alarming trends regarding post-nasal fracture olfactory dysfunction. First, our study demonstrated that almost half (46.4%) of nasal fracture patients experience posttraumatic olfactory dysfunction. Second, closed reduction of these fractures does not lead to improvements olfaction at 6 months, which suggest that olfactory dysfunction is probably due to factors other than the fracture itself. The association should be further explored between injuries that lead to nasal fracture and the mechanism behind posttraumatic olfactory dysfunction.

Keywords

References

  1. Basheeth N, Donnelly M, David S, Munish S. Acute nasal fracture management: a prospective study and literature review. Laryngoscope 2015;125:2677-84.
  2. Kucik CJ, Clenney T, Phelan J. Management of acute nasal fractures. Am Fam Physician 2004;70:1315-20.
  3. Mondin V, Rinaldo A, Ferlito A. Management of nasal bone fractures. Am J Otolaryngol 2005;26:181-5.
  4. Hwang K, You SH, Kim SG, Lee SI. Analysis of nasal bone fractures: a six-year study of 503 patients. J Craniofac Surg 2006;17:261-4.
  5. Rohrich RJ, Adams WP Jr. Nasal fracture management: minimizing secondary nasal deformities. Plast Reconstr Surg 2000;106:266-73.
  6. Rhee SC, Kim YK, Cha JH, Kang SR, Park HS. Septal fracture in simple nasal bone fracture. Plast Reconstr Surg 2004;113:45-52.
  7. Haug RH, Prather JL. The closed reduction of nasal fractures: an evaluation of two techniques. J Oral Maxillofac Surg 1991;49:1288-92.
  8. Murray JA, Maran AG, Mackenzie IJ, Raab G. Open v closed reduction of the fractured nose. Arch Otolaryngol 1984;110:797-802.
  9. Park HK, Lee JY, Song JM, Kim TS, Shin SH. The retrospective study of closed reduction of nasal bone fracture. Maxillofac Plast Reconstr Surg 2014;36:266-72.
  10. Ridder GJ, Boedeker CC, Fradis M, Schipper J. Technique and timing for closed reduction of isolated nasal fractures: a retrospective study. Ear Nose Throat J 2002;81:49-54.
  11. Hwang K, Yeom SH, Hwang SH. Complications of nasal bone fractures. J Craniofac Surg 2017;28:803-5.
  12. van Damme PA, Freihofer HP. Disturbances of smell and taste after high central midface fractures. J Craniomaxillofac Surg 1992;20:248-50.
  13. Fan LY, Kuo CL, Lirng JF, Shu CH. Investigation of prognostic factors for post-traumatic olfactory dysfunction. J Chin Med Assoc 2015;78:299-303.
  14. Haxel BR, Grant L, Mackay-Sim A. Olfactory dysfunction after head injury. J Head Trauma Rehabil 2008;23:407-13.
  15. Dursun E, Battal B. Olfactory dysfunction following nasal trauma. Int J Otorhinolaryngol 2008;10:1-4.
  16. Coelho DH, Costanzo RM. Posttraumatic olfactory dysfunction. Auris Nasus Larynx 2016;43:137-43.
  17. Yousem DM, Geckle RJ, Bilker WB, Kroger H, Doty RL. Posttraumatic smell loss: relationship of psychophysical tests and volumes of the olfactory bulbs and tracts and the temporal lobes. Acad Radiol 1999;6:264-72.
  18. Renzi G, Carboni A, Gasparini G, Perugini M, Becelli R. Taste and olfactory disturbances after upper and middle third facial fractures: a preliminary study. Ann Plast Surg 2002;48:355-8.
  19. Costanzo RM, Miwa T. Posttraumatic olfactory loss. Adv Otorhinolaryngol 2006;63:99-107.
  20. Hong SC, Yoo YS, Kim ES, Kim SC, Park SH, Kim JK, et al. Development of KVSS test (Korean version of Sniffin' sticks test). Korean J Otolaryngol 1999;42:855-60.
  21. Stranc MF, Robertson GA. A classification of injuries of the nasal skeleton. Ann Plast Surg 1979;2:468-74.
  22. Costanzo RM, DiNardo LJ, Zasler ND. Head injury and taste In: Doty RL, editor. Handbook of olfaction and gustation. New York: Marcel Dekker; 1995. p. 775-83.
  23. Welge-Lussen A, Hilgenfeld A, Meusel T, Hummel T. Long-term follow-up of posttraumatic olfactory disorders. Rhinology 2012;50:67-72.
  24. Kalavrezos ND, Graetz KW, Eyrich GK, Sailer HF. Late sequelae after high midface trauma. J R Coll Surg Edinb 2000;45:359-62.
  25. Costanzo RM, Becker DP. Smell and taste disorders in head injury and neurosurgery patients. In: Meiselman HL, Rivlin RS, editors. Clinical measurement of taste and smell. New York: Macmillan; 1986. p. 565-78.
  26. Kimmelman CP. The risk to olfaction from nasal surgery. Laryngoscope 1994;104:981-8.

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